(Updated: 2020-05-20 14:08:17 EDT)
So, I have been watching the epidemic in China and Korea since the beginning, but it is still not easy to settle into this reality here in the US.
First of all, everyone, STAY HEALTHY and see what YOU can do!
Second, there are many excellent news articles and information sources, but I’m sharing some more questions (see left panel) and answers for those who are curious about a specific situation in Maryland, US - especially including local data. Maryland is my beautiful adopted home state of over 20 years. The State is doing its best with strong leadership, but this virus arrived here when the country was not ready and is spreading fast unfortunately…
See footnote for further information about data sources. More questions and answers will be added, as more local data become available.
(Sorry, this is not mobile device friendly, and is best viewed on your regular monitor.)
Answers to Question 5 show latest case fatality rate (i.e., deaths per 100 COVID-19 cases) by county and how it has changed in the State. But, how about across different age groups? Case fatality rate has increased continuously in older age groups. The rate of increase is highest among people who are 80 and older.
The Maryland Department of Health started publishing data by race (i.e., the number of cases and deaths by race) on April 9th, following an upsetting report about racial disparity in COVID mortality in the US: higher morality in states with higher proportions of black population. Further data - specifically disaggregated by individual people’s race, beyond the state-level analysis - are crucial to monitor and understand the disparity. Also, though initially unavailable, a separate category for Hispanic population is published on April 15. As a resident of Maryland, I am very proud of the state’s rapid action to publish race data!
Now with Hispanic population disaggregated from “other”, the pattern of incidence and mortality by race/ethnicity can be examined better. In terms of rates (important to compare across races with different population sizes), the incidence rate is substantially higher among Hispanic, followed by African American population (blue bars). And, incidence rate among Hispanic population has increased most rapidly - see the second figure below.
However, case fatality rate is highest among White and Asian Americans (orange bars). This implies that the disproportionately higher number of deaths among African American population in Maryland is because of the higher rate of infection, not because of higher risk of dying among those who are infected. At the same time, it is notable that, though the infection rate is lower, mortality risk is higher among Asian Americans in Maryland.
To understand reasons behind this, we will need to learn more about characteristics of patients by race (e.g., Do Asian Americans with COVID tend to be older and/or have existing conditions in Maryland? Are Hispanic Marylanders with COVID younger than their counterparts?) and any differences in access to health care by race among COVID patients. Also, what can we do to reduce the higher infection rate among African Americans and Hispanic population in Maryland? Finally and importantly, if and when we have better data on race (i.e., less cases with missing race information), the findings on racial disparity may well change (see below note on race data in Maryland).
Hover over each figure to see values and more options.
(Source: Maryland Department of Health’s Maryland COVID-19 Case Map Dashboard, and Maryland Department of Planning’s Population Estimates by Race and Hispanic Origin for July 1, 2018) (Source: Maryland Department of Health’s Maryland COVID-19 Case Map Dashboard, and Maryland Department of Planning’s Population Estimates by Race and Hispanic Origin for July 1, 2018)Important note on race data in Maryland:
1. 18 % of cases do not have race information. This is likely because private labs are not required to report race. All data shown here is only based among cases and deaths with known race.
2. In Maryland, “Other” population includes: American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander, and ‘Two or more races’ - accounting for about 3% of total population in the state. Figures do not include “Other” races, given possibility that Hispanic population might have been included in this category initially.
As of 2020-05-20 10:00AM, 2004 COVID-19-positive deaths have occurred, according to Maryland Department of Health. This means 4.7 percent of all confirmed cases. Below figure shows mortality by county - in terms of both absolute number (red bars) and case fatality rate (orange bars) as of 2020-05-19.
(Note: MD Health Department has published the number of probably COVID deaths since April 15. Those deaths have not been included in analyses here.)
(Source: New York Times’ Coronavirus in the U.S.: Latest Map and Case Count, US Census Bureau’s County Population Totals: 2010-2019)Below chart shows the mortality trends, since March 18 when the first COVID-19 death was reported in Maryland. Globally in countries severely affected by the epidemic before US, case fatality rates increased rapidly in the beginning. The rates then stabilized in some of the countries, depending on health systems’ response and characteristics of patient population.
(Source: New York Times’ Coronavirus in the U.S.: Latest Map and Case Count, US Census Bureau’s County Population Totals: 2010-2019)
This is a very important question, since the magnitude of testing over time is critical information to understand the epidemic. I got trend data on testing in Maryland from COVID-19 Case Map Dashboard by Maryland Department of Health also COVID Tracking Project for earlier data. Still, data on the number of new tests are not available between 3/12 and 3/28.
As of 2020-05-20 10:00AM, a total of 215330 tests have been conducted. There are about 6 million people in Maryland, and this means 35.6 tests have been conducted in every 1000 people. However, a high rate of positive test indicates that testing is still limited to those with symptoms primarily, not based on effective contact tracing. Ideally, the positive test rate should be well below 10%. Both the high level and its increasing trend in Maryland is worrisome, compared to the national status.
Below shows the number of new tests and the positive rate by date in Maryland.
(Source: Maryland Department of Health’s Maryland COVID-19 Case Map Dashboard)Initially, COVID-19 has affected adult population relatively evenly across different ages (approaching or above 300 per 100,000 population in all age groups 30 and above). Recently, however, the incidence rate has increased more rapidly among those 80 and older (see the second figure). Currently, the incidence rate is highest, 1413 per 100,000 population, among people 80+ years of age.
(Source: Maryland Department of Health’s Maryland COVID-19 Case Map Dashboard, and Maryland Department of Planning’s Population Estimates by Race and Hispanic Origin for July 1, 2018) (Source: Maryland Department of Health’s Maryland COVID-19 Case Map Dashboard, and Maryland Department of Planning’s Population Estimates by Race and Hispanic Origin for July 1, 2018)Since testing capacity has been low, we cannot confidently answer this question. Nevertheless, we can see the number of NEW confirmed cases each day. The first figure is for the entire state. We want to see the number of new infections to be stable more or less, without sudden and large increases. On 2020-05-19, 1782 new cases were confirmed, compared to 962 on the previous date. The (now relatively small) peak on March 28th was due to new cases in Carroll county on March 28 - see the second figure below.
Hover over each figure to see values and more options.
(Source: New York Times’ Coronavirus in the U.S.: Latest Map and Case Count)Now, among 16 counties with 200 or more confirmed cases, below shows the trends of daily number of NEW confirmed cases for each of the county, with 7-day rolling average with a black line. Again, large spikes on April 8th may well be results of delayed processes in laboratory and/or data entry, not actual increases on that date.
Hover over each figure to see values and more options.
(Source: New York Times’ Coronavirus in the U.S.: Latest Map and Case Count)
As of 2020-05-20 10:00AM, 42323 confirmed cases have been reported in Maryland, according to Maryland Department of Health. This means there are 700 people with confirmed COVID-19 per 100,000 population in the state.
Below figure shows number of confirmed cases by county by the end of 2020-05-19.
Hover over each figure to see values and more options.
(Source: New York Times’ Coronavirus in the U.S.: Latest Map and Case Count)When we look at infection rates (i.e., number of confirmed cases per 100,000 population), Prince George’s county now has the highest rate currently.
Hover over each figure to see values and more options.
(Source: New York Times’ Coronavirus in the U.S.: Latest Map and Case Count, US Census Bureau’s County Population Totals: 2010-2019)Data sources:
1. All COVID-19 data for counties come from New York Times’ Coronavirus in the U.S.: Latest Map and Case Count. Accessed on 2020-05-20.
2. All COVID-19 data for Maryland disaggregated by age and sex come from Maryland COVID-19 Case Map Dashboard by Maryland Department of Health. This dashboard presents latest numbers as of 10:00AM on each day. Accessed on 2020-05-20.
3. All data on county population come from US Census Bureau’s County Population Totals: 2010-2019. Accessed on March 29, 2020.
4. Data on Maryland population by age and sex come from Maryland Department of Planning’s Population Estimates by Race and Hispanic Origin for July 1, 2018. Accessed on April 1, 2020.
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